Aims: To provide a comprehensive literature review of the otologic manifestations in RA and discuss potential pathogenesis and risk factors. Methods: We screened the MEDLINE, Scopus, and Embase databases, and Google Scholar for articles involving patients with RA who presented otological manifestations up to May 2025, including meta-analyses, systematic reviews, observational studies, case series, and case reports published in English and/or Spanish. Results: Rheumatoid arthritis (RA), besides affecting articulations, may be involved in other systems, including the cardiovascular, neurological, ocular, cutaneous, respiratory, renal, and gastrointestinal systems. Otologic manifestations, such as hearing loss, tinnitus, Meniere's disease, and vertigo, are relatively common in patients with RA. Hearing loss shows a notable prevalence, with an average rate of 16.14% among RA patients, an odds ratio of 3.42, and a relative risk of 2.28 when compared to the general population. Conclusions: Given the high prevalence and impact of otologic manifestations in RA patients, a multidisciplinary approach involving both rheumatologists and otolaryngologists is essential for proper diagnosis and management. Early recognition of hearing loss and other otologic symptoms by rheumatologists may prevent complications and improve patients' quality of life.